Clinical Governance. Dr. Hamda Qotba , B.Med.Sc ; MD; ABCM; MFPH. What is clinical governance?.
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Dr. HamdaQotba, B.Med.Sc; MD; ABCM; MFPH
‘a system through which all of the organizations in the health system are accountable for continuously improving the quality of their clinical services and ensuring high standards of patient care by creating a facilitative environment in which excellence will flourish ‘
System that enable staff to work in the best possible way
Staff performing to the highest possible standards
Clinical risk ( self and program (s))
Job plan and individual performance
Clinical standards NSFs
National confidential inquiries
Considered as tool not goal
The process of systematically finding, appraising, and using contemporaneous research findings as the basis for clinicaldecisions
Being health professional you should aim to do only those medical activity that you have evidence it will work successfully
Bounds by which all practices in a givenarea will be carried out, in achieving the goals and objectives for that area
This forms the basis for evidence-based medicine. The NHS Research and Development strategy was launched in 1991 to develop a knowledge-based NHS in which decisions (clinical, policy and managerial ) would have a sound base.
This strategy will continue to have pivotal role in collecting new evidence, with support from the Horizon Scanning Center and the National Prescribing Center in identifying new and existing interventions.
The process of minimizing risk to an organization by developing systems to identify and analyzepotentialhazards to prevent accidents, injuries, and other adverse occurrences, and by attempting to handle events and incidents which do occur in such a manner that their effect and cost are minimized.
Effective risk management has its greatest benefits in application to insurance in order to avert or minimise financial liability.
Process of regularly reviewing achievements and progress towards the goals (day to day )
Process measuring the degree to which objectives and targets are fulfilled and the quality to the result are obtained
Evaluation and audit requires the assessment of effectiveness and efficiency and the formulation of recommendations to promote improvement. In appraising these elements, however, audit differs from evaluation in orientation or objectives
The four existing national confidential inquiries
preoperative death, stillbirths and deaths in infancy, maternal deaths and suicides
overseen by NICE.
This will highlight areas in the job that are not being met, both presently and as the job develops.
This is about developing a culture that encourages lifelong learning ( the learning organization ) and is an integral part of the job plan. Health organization should commit, plan and act on ‘investment in people’ if they are truly interested in delivering quality clinical care
Complaints will be monitored both externally and internally. There will have to be an effective local system in place to deal with complaints. Documentation will be particularly important in order to facilitate external scrutiny.
This will establish the required staffing levels to achieve acceptable standards of care. However, this is not just about recruiting the appropriate staff, but also about retaining them.
This is to be encouraged. If poorly performing work colleagues are not dealt with/reported, responsibility will be shared. This balance between collective and individual responsibility must be appreciated.
our ability to critically appraise the strength of the evidence available and its application should be part of our routine practice.
both internal and external peer-review will be an important tool for assessing the effectiveness of the clinical governance culture and in creating a facilitative environment in which excellence can flourish
For clinical governance to be successful, the following must be in place: